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Northern Football Combine

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					                                   Northern Football Combine 2010
                                                       Registration Form
        Player Information:
        Complete top portion and return by e-mail to cachous_09@hotmail.com
         First Name:                                                       Player in: High School:                     Community:
         Last Name:                                                        Years of Experience:
         Address:                                                          Offence Position #1
         City:                                                                              #2
         Postal Code:                                                      Defence Position #1
         D.O.B.                                                                             #2
         Care Card:                                                        Practice Pant size:
         Allergies:                                                        Practice Jersey size:
         Medical Concerns:                                                 Girdle size:
                                                                           T-Shirt size:

       Parent/Guardian Information:                    Emergency Contact Information:
        First Name:                                         (if different from parent/guardian)
        Last Name:                                          First Name:
        Phone #:                                            Last Name:
        Cell#:                                              Phone #:
        Relationship: Parents                               Relationship:
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(to be signed at equipment night)
   I/We, the guardian of the above named candidate for a position on a Minor Football team, hereby give my/our approval to participate in any and
   all League activities. I/We assume all the risks and hazards incidental to such participation including transportation to and from the activities:
   and I/We do hereby waive, release, above, indemnify and agree to hold harmless the local Football League, Prince George Minor Football
   Association, the organizers, sponsors, supervisors, participants and persons transporting my/our child to and from activities, for any claim
   arising out of an injury to my/our child, whether the result of negligence or for any other cause, except to the extent and in the amount covered
   by accident or liability insurance. I/We agree to return upon request the uniform and other equipment issued to our child in as good a condition
   as when received except for normal wear and tear. I/We will furnish a birth certificate to League Officials to verify age at registration. I/We will
   furnish a copy of a birth certificate to League Officials if required by tournament rules.


   Legal Guardian:                                                                              Date:
    Internet Concent
    I understand that my child’s image may be published on the Internet. This image may take form of a photograph or video. No last name, home
    address, telephone number will appear on such image.
                                         Signature:__________________________________________________
(for registration use only)
Registration Information:
 Shoulder Pad#:                                        Payment: cheque                cash          Amount:
 Helmet #:                                             Receipt#
Spirit Packs:
 Pant:          Jersey:                        Girdle:                  Socks:                  Mouth guard:                    T-Shirt:

         PROUDLY SPONSORED BY: PRINCE GEORGE MINOR FOOTBALL ASSOC.

				
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